In Reply.—Dr Khera is correct in saying that foreign physicians found it relatively easy to come to the United States a few years ago and that only a small number of foreign medical graduates can find residency opportunities today in our relatively rigidly organized education programs.The FMGEMS was a necessary development to address former inequities. The approximate pass rate fluctuates between 25% and 30%. Our clinical skills test pilot study is part of the broad issue of testing clinical skills in all medical school graduates, an issue that will require further discussion in the coming months.The principal focus of our comments concerned an expanded exchange visitor program that would provide more educational opportunities in the United States for foreign medical graduates, with a clear understanding that the individual must return to his or her home country and contribute to the improvement of health care in that country.